Osteoporotic vertebral fractures may be under-reported by some radiologists, thus missing an opportunity for diagnosis and treatment and reducing the risk of future hip fractures, according to a report highlighted by the International Osteoporosis Foundation (IOF).

Osteoporotic fractures can be an early warning sign of future hip fractures. However, recent research estimated that less than half of detectable vertebral fractures are reported at the time of routine imaging. 

Fractures missed

The IOF has highlighted a newly published study from the University of Oxford that found that within a group of hip fracture patients, many had previous routine imaging showing incidental vertebral fractures. However, over half of these were not reported by radiologists. Most likely this was because they were not specialised in musculoskeletal imaging, suggests the study.¹

The researchers used data on 731 patients treated by the local fracture liaison service. Of those that had undergone a radiological procedure involving the spine, in 54% of cases vertebral fractures were not picked up. 

The study authors highlight the importance of picking up vertebral fractures from routine imaging of older patients in particular. In addition, they point to the importance of having an effective referral system to ensure that these patients are sent to fracture prevention services. This should lead to more patients receiving osteoporosis therapy, thus reducing the number of future hip fractures and the associated mortality and morbidity. 

World Osteoporosis Day

Meanwhile World Osteoporosis Day spearheaded by the IOF will be marked on October 20 and is dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis and related bone diseases. It aims to put osteoporosis and fracture prevention on the global health agenda to spread prevention messages to healthcare professionals, the media, policy makers and the public at large.

Specifically, the 2017 World Osteoporosis Day campaign will urge people to ‘Love your bones – Protect your future’ and aims to:

• Promote worldwide awareness of osteoporosis and understanding of the heavy toll the disease can take on an individual’s future if left undiagnosed and untreated.
• Improve understanding of the link between osteoporosis and fractures - which can be a major cause of disability and early death in older adults
• Encourage individuals to recognise risk factors, including first fractures, and to seek testing and treatment if required in order to protect their longer-term future
• Promote bone-healthy nutrition and exercise as essential to good bone health, as well as awareness of the role of calcium, good nutrition, and regular exercise during childhood and adolescence when bones are developing
• Advocate for preventive care worldwide: enable healthcare professionals and health authorities to close the persistent ‘care gap’ by addressing critical issues such as under-diagnosis and under-treatment, lack of fracture liaison services to systematically identify and treat high risk patients, and poor adherence to treatment.

The World Osteoporosis Day campaign calls on the general public to take early action to protect their bone and muscle health, in order to enjoy a good quality of life and independence in the future. Similarly, it calls on health authorities and physicians to protect their communities’ bone health.

Despite the many effective treatment options, osteoporosis often remains undiagnosed and undertreated. By ‘closing the care gap’ through timely assessment and treatment health professionals, health authorities, and hospitals can work together to reduce the human and socioeconomic burden of fragility fractures, says the IOF.

Reference

1. Mitchell RM, Jewell P, Javaid MK, McKean D, Ostlere SJ. Reporting of vertebral fragility fractures: can radiologists help reduce the number of hip fractures? Arch Osteoporosis 2017 Dec;12(1):71. doi: 10.1007/s11657-017-0363-y. Epub 2017 Aug 7. https://link.springer.com/article/10.1007%2Fs11657-017-0363-y